Frequency, Severity, Rate, and Causes of Moral Distress among Nursing Students: A Cross-Sectional Study

Table 3

The most important factors influencing students' moral distress.

Phrases	Total		Frequency		Intensity
	Mean ± SD^a	Rank	Mean ± SD	Rank	Mean ± SD	Rank
Working and caring for the patient in unsafe conditions due to the small number of nurses.	6.9 ± 6.0	1	2.1 ± 1.5	1	2.5 ± 1.3	1
Observing the disorder in the process of patients care due to the displacement and diversity of caregivers.	5.4 ± 5.6	2	2.0 ± 1.4	2	2.3 ± 1.5	2
Observing the low quality of patients care due to poor group communication.	5.1 ± 4.6	3	1.9 ± 1.2	3	2.7 ± 1.7	3
Discharge of a patient who has not been given the necessary training despite a long hospital stay.	4.9 ± 5.6	4	1.8 ± 1.3	4	2.2 ± 1.4	4
Performing a treatment process when the patient does not have accurate and sufficient information about it.	4.5 ± 4.6	5	1.8 ± 1.4	5	2.2 ± 1.3	5
Working with colleges who did not have the competency for patients care.	4.3 ± 4.6	6	1.7 ± 1.5	6	2.1 ± 1.5	6
Providing better care to rich patients compared to nonaffluent patients.	4.1 ± 5.4	7	1.7 ± 1.2	7	2.1 ± 1.5	7
When the students were allowed to perform a painful procedure on the patient to increase their skills without the presence of a supervisor.	4.0 ± 4.4	8	1.7 ± 1.4	8	2.1 ± 1.6	9
Just witnessing, and not intervening in cases where staff do not respect the patient's rights.	3.8 ± 4.9	9	1.6 ± 1.4	9	2.1 ± 1.5	10
Providing less-than-desirable care due to pressure from managers or insurance companies to reduce costs.	3.7 ± 4.4	10	1.5 ± 1.4	10	2.0 ± 1.3	11
Implementing the organizational guidelines and policies to discontinue treatment when the patient does not pay for treatment.	3.6 ± 5.3	11	1.4 ± 1.3	11	2.0 ± 1.3	12
Doing a doctor's prescription for tests and treatments that I think are unnecessary.	3.6 ± 4.8	12	1.4 ± 1.4	12	2.0 ± 1.4	13
An overviewing of the situation where the patient has not been given accurate information about consent.	3.6 ± 4.8	13	1.3 ± 1.3	13	2.0 ± 1.3	14
Coverage and nonreporting of errors which were done by the physician or errant nurse.	3.4 ± 4.8	14	1.3 ± 1.4	14	1.9 ± 1.5	15
Coverage of suspected cases of patient abuse by caregivers.	3.4 ± 4.8	15	1.2 ± 1.3	16	1.8 ± 1.3	17
Ignoring the observed moral issues, due to the request of the wrongdoer or the person in the position of power.	3.2 ± 4.2	16	1.2 ± 1.1	17	1.8 ± 1.2	18
Helping a physician who I think provides poor treatment and care.	3.0 ± 4.9	17	1.9 ± 1.3	15	1.9 ± 1.4	16
Assisting a physician who performs the test or treatment without the patient's consent.	2.9 ± 4.7	18	1.19 ± 1.3	18	2.1 ± 1.5	8

Note.^aSD: standard deviation.